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March 12, 2026Scientific Reports2 citationsOpen Access

Evaluation of bone changes in patients born premature using mandibular indices and fractal dimension analysis on dental panoramic radiographs

ACAlem CoşgunMTMerve TatarMDMüzeyyen Dilşah Demiray

Key Points

  • This study evaluates bone changes in prematurely born children compared to peers born at term.
  • Analyzed panoramic radiographs of 152 children (76 premature, 76 control)
  • Used fractal dimension analysis, mandibular cortical index, and panoramic mandibular index
  • Conducted logistic regression to assess risk factors for porous bone structure
  • Premature group exhibited higher prevalence of deteriorated cortical bone patterns (MCI Type 2/3)
  • Increasing age and gestational age significantly reduced the risk of porous bone structure
  • FD values were lower in prematurely born compared to term-born children, indicating compromised microarchitecture

Abstract

Our study aims to assess mandibular trabecular bone microarchitecture and cortical bone density in prematurely born children compared to term-born peers, using fractal dimension (FD) analysis and mandibular cortical index (MCI) and panoramic mandibular index (PMI) derived from panoramic radiographs. Our study included 152 panoramic radiographs obtained for diagnostic purposes from 76 premature group (30 girls and 46 boys) and 76 control group (30 girls and 46 boys). The mean age of the premature group was 7.35 ± 1.92, and that of the control group was 7.33 ± 1.9. Analyses revealed that premature individuals had a significantly higher prevalence of deteriorated cortical bone patterns (MCI Type 2/3) compared to controls (p < 0.001). Logistic regression analysis showed that increasing age (OR: 0.541; p = 0.002) and gestational age (OR: 0.696; p = 0.045) significantly reduced the risk of developing porous bone structure. FD values in the left condyle and right interdental region were statistically significantly higher in the control group than in the patients born premature group (p < 0.05). FD analysis shows partially compromised mandibular trabecular microarchitecture in patients born premature. MCI distribution reveals greater cortical bone thinning and irregularity. These findings suggest reduced quality and long-term fragility. Clinical caution is necessary regarding alveolar resorption. Monitoring the potential long-term effects of increased preterm survival on bone quality and jawbone structure represents an important clinical requirement from both pediatric and dental perspectives.

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Cite This Study

Coşgun et al. (2026) studied this question.

synapsesocial.com/papers/69b2583896eeacc4fcec79bfhttps://doi.org/10.1038/s41598-026-43597-3
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